Modeling and clinical data align on optimal pupil size for presbyopia therapy

Pharmacologic treatments for presbyopia achieve near-optimal pupil sizes for improving near vision while maintaining image quality, according to a recent comment that incorporates optical modeling and clinical data.

Investigators used optical modeling alongside clinical trial data to define an optimal target pupil size.

Results showed that smaller pupil sizes, between 1.5 mm and 2.5 mm, significantly increased depth of focus while preserving acceptable image quality. These findings were consistent with clinical trial data, where pilocarpine treatments typically produced pupil diameters of 2.0 mm to 2.5 mm and were associated with meaningful improvements in near vision.

The analysis found that these clinically achieved pupil sizes closely align with a theoretically optimal range of 2.0 mm to 3.0 mm identified through modeling.

Reference
De Gracia P, Pucker AD. Pharmacological Modulation of Pupil Size in Presbyopia: Optical Modeling and Clinical Implications. J Clin Med. 2025;14(17):6040. doi: 10.3390/jcm14176040. PMID: 40943800; PMCID: PMC12428952.